WIM 14 BOROUGH OF WIMNLEDON Public Health Department ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR ENDED 31st DECEMBER, 1941 STAFF . Whole-time. Medical Officer of Health; School Medical Officer; Medical Superintendent of the Infectious Diseases Hospital; Materni'ty and Child Welfare Officer; ‡ * HAROLD ELLIS, M.B.. B.S.(Lond.), M.R.C.S., L.R.C.P., D.P.H. Deputy Medical Officer of Health, Assistant School. Medical officer: ‡ PATRICK J. DOODY, M.B., F,Ch., D.P.H, Senior Sanitary Inspector: * R. T. AVIS, M.R.San.I., M.S.I.A., (c), (e), (f). Sanitary Inspectors: * D. F. S. FLYNN, (e), (f). * C. W. SOUTHERBYi (e), (f). ø * A. A. REED, (e), (f). ø * H. R. FRY, (e). Health Visitors - School Nurses: MISS V. B. W00DR0FF, (b),(c), (g). MISS P.N. NASH, (a), (b), (d). MISS J. C. MOFFAT, (a), (b), (d), (h). MISS E.S.G-.DAVIES, (a), (b), (d), (h). MRS. E. A. JONES, (a), (b), (d). Matron of Infectious Diseases Hospital. MISS I. MULHERN. Matron of Day Nursery: MISS I.CUTLER. Senior Clerk: A.L. TAYLOR. Clerks: ø J. E. FIELD. J. BURROWS. Clerk to the Maternity and Child Welfare Department: A. L.TAYLOR PART-TIME. LESLIE H. W. WILLIES, F.R.C.S., F.C.O.G., Obstetric Consultant. S. TAYLOR HARRIS, M.R.C.S., L.R.C.P., Medical Officer to Ante-natal Clinic. MaRY M. TULLOCH, M.B., B.S., Medical Officer to Maternity and Child Welfare Centres. W. L. GALVIN, M.B., B.Ch., Deputy Medical Attendant Infectious Diseases Hospital. R. J. FURLONG, F.R.C.S., Orthopaedic Surgeon. R. J. CANN, M.S., Surgeon to Aural Clinic. A. MCALLISTER, F.R.C.S., Consulting Obstetrician under Public Health (Notification of Puerperal Fever and Puerperal Pyrexia) Regulations, 1926. Col. E. MIDDLETON PERRY, C.B.E., F.R.C.V.S., Veterinary Inspector. J. H. JOHNSTON, M.So,, L.S. A., Bactoriologist. * Salary contribution under Public Health Acts. ‡ " " by Exchequer Grants. a S . R.N. b. S.C.M. c. Certificate Sanitary Inspectors Examination Board (London)* d. New Health Visitor's Certificate, Royal Sanitary Institute. e Certificate Royal Sanitary Institute for Inspector of Nuisances. f. Certificate Royal Sanitary Institute for Inspector of Meat and other Foods, g. Diploma Board of Education (Health Visitors' Training) Regulations,1919. h. Certificate of Fever Training. ø Serving with H.M.Forces. ANNUAL REPORT of the Medical offficer of Health 1941 To the Mayor, Aldermen and Councillors of the Borough of Winbledon. Mr. Mayor, Ladies and Gentilmen, I have the honour to submit the Annual Report on the work of the Public Health Department for the year endsd 31st December, 1941 The Report for 1941 is. an ordinary report compiled in accordance with the instructions contained in Circular 2604 of the Ministry of Health. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Area (in acres - Census, 1931) 3,221 Population (Census, 1931) 59,524 Number of inhabited houses 1921 (Census) 11,926 1931 (Census) 13,325 Number of families or separate occupiers:- 1921 (Census) 13,998 1931 (Census.) 15,883 Rateable Value:- £314.700 Sum represented by a penny-rate:-- £*3978 Extracts from Vital Statistics of the Year 1941. (Registrar-General's Figures) For Calculation of Infantile Mor- Birth Rate - tality Total elc. Total M. F. M. F. (Legitimate 449 215 234 518 249 269 Live Births (Illegitimate 37 18 19 39 20 19 (Total 486 233 253 557 269 288 Birth Rate per 1,000 of the estimated resident population 12,82 Total .M. F. Total M. F. (Legitimate 10 6 4 13 7 6 Stillbirths (Illegitimate - - - - - - (Total 10 6 4 13 7 6 Rate per 1,000 total (live and still) births 22,80 Total M. F. 617 280 337 Death rate per 1,000 of the estimated resident 11.92. 2. Deaths from puerperal causes (Headings 29 and 30 of the Registrar-General's Short List) Deaths. Rate per 1,000 total (live & still) births No, 29 Puerperal & postabortive sepsis - - No. 30 Other maternal causes - Total - - Death Rate of Infants under one year of age:- All infants per 1,000 live births 41.15 Legitimate infants per 1,000 legitimate live births 37,86 Illegitimate infants per 1,000 illegitimate live births 81.08 Deaths from Cancer (all ages) 87 " " Measles (all ages) " " Whooping Cough (all ages) 1 " '' Diarrhoea (under 2 years of age) - Birth Rates, Civilian Death Rates, Analysis of Mortality, Maternal Death Rates, and Cose Ratos For certaia Infectious Diseases in the Year, 1941. (Provisional figures based on weekly and quarterly returns) Wimble don. England & Wales 126 C.B'S & Great i Towns including London 148 Smaller towns (Resident pop. 25,000 50,000 at 1931 Census) London Administra tive County Rates per 1,000 Civilian Population Live Births 12.82 14.2 14.7 16.4 8.9 Still Births 0.29 0.51 0.58 0.60 0.33 Deaths All Causes 11.92 12.9 14.9 13.0 16.3 Typhoid & Paratyphoid 0.00 0.00 0.00 0.00 0.01 Small-pox — — — — — Measles 0.00 0.03 0.03 0.03 0.02 Scarlet Fever 0.00 . 0.00 0.00 0.01 0.00 Whooping Cough 0.02 0.06 0.07 0. O6 0.04 Diphtheria 0.00 0.07 0.06 0.06 0.03 Influenza 0.1S 0.19 0.17 0.20 0.15 Violence 0.73 * * * * Notifications:- Smallpox — — — — — Scarlet Fever 0.94 1.47 1.49 1.51 1.01 Diphtheria 0.32 1.25 1.53 1.19 0.93 Typhoid Fever — 0.03 0.02 0.03 0.04 Paratyphoid Fever 0.18 0.09 0.12 0.09 0.05 Oerobro-Spinal Fever 0.20 0.25 0.31 0.20 0.30 Measles 1.77 10,33 8.27 10.47 4.77 Whooping Cough 3.31 4.39 4.37 4.50 3.50 Erysipela 0.20 0.30 0.36 0.27 0.50 Pneumonia 0.48 1.25 1.53 1.04 1.07 . Rates per 1,000 Live Births Infant Mortality Deaths under 1 yr.ofage 41 59 71 56 68 Deaths from Diarrhoea & Enteritis (under two years of age) 0.00 5.1 7.5 4.6 6.8 3 Rates per 1,000 Total Births (i.e., Live and Still) Maternal Mortality (Excluding Abortion):- Puerperal Infection 0.00 0.40 * * * Others 0.00 1.75 Total 0.00 2.23 Notifications Puerperal Fever ., .. 2.29 " Pyrexia 4.01 11.91 15.64 9.43 19,3 * Not available. Including Puerperal Fever. Births.- The statistics supplied by the Registrar-General show that during 1941 the total number of registered live births belonging to Winblodon amounted to five hundred and fifty-seven, (two hundred and sixty-nine males and two hundred and eighty-eight females). This gives a birth rate equal to 12,82 per thousand of the population. Thirtynine of the births were illegitimate. Of this number twenty were males and nineteen females. In addition, thirteen stillbirths (seven males and six. females) were registored. Public Health Act. 1936 - Notification of Births. During the year four hundred and thirty-eight births were notified by the following persons Parents 2 Midwives 181 Doctors 10 Other persons 245 Total 438 Eleven of these notifications were in respect of stillbirths. Of the four hundred and thirty-eight notifications, two hundred and six were received from Medical Officers of Health of outside areas, and related to births which had occurred to Wimbledon residents Confined outside the Borough, Similarly, eighteen confinements occurrod in Wimbledon amongst women whose homes were situated in other districts. The nett number of notified births belonging to Wimbledon is, therefore, four hundred and twenty. Deaths,- The total number of deaths registered in the district was four hundred and eighty-one (one hundred and ninety-one males and two hundred and ninety females), equal to a death rate of 11,07 per thousand of the population. The deaths occurring out.ido the c'intrict, of persons belonging to this Borough were two hundred and sixty-five. The deaths occurring within the district, of persons not belonging thereto were one hundred and twenty-nine. Taking these figures into consideration, .the total number of deaths properly belonging to. Wimblodon -is six hundred and seventeen and the crude death rate 14.20 per thous-and of the population. The death rate shows a marked decrease on the figure for the previous year. 4. The crude death rate is, strictly speaking, not comparable with the figure for England and Vales. ??? to provide for this the Registrar-General iutroouced ??? an areal comparability factor. This factor, ??? is not available this year, but assuming it to be the same as for 1940 the adjusted death rate for Wimbledon would bo 11.92 per thousand of the population as compared with a figure of 12.9 per thousand for England and Wales. causes of death. Males Females Total 1, Typhoid and paratyphoid fevers — — — 2. Cerebro-spinal fever 1 2 3 3. Scarlet Fever — — _ 4. Whooping cough 1 — 1 5, Diphtheria — — — 6, Tuberculosis of respiratory system 13 16 29 7 Other forms of tuberculosis 1 2 3 8. Syphilitic diseases 2 1 3 9. Influenza 7 1 8 10, Measles — — — 11. Acute poliomyelitis & polioencephalitis — — — 12. Acute infectious encephalitis — — — 13. M. Cancer of buccal cavity and oesophagus (males-onlyj 2 — 2 13. E Cancer of uterus - 4 4 14. Cancer of stomach and duodenum 10 7 17 15. Cancer of breast — 13 13 16. Cancer of all other -sites 25 ,26 51 17. Diabetes 3 2 5 18, Intra-cranial vascular lesions 20 57 77 19, Heart disease 67 85 152 20. Other diseases of the circulatory 7 9 16 21. Bronchitis 19 16 35 22. Pneumonia 22 18 40 23. Other respiratory diseases 5 8 13 24. Ulcer of the, stomach or duodenum 4 2 6 25. Diarrhoea (under 2 years of age) — — — 26. Appendicitis 2 1 3 27. Other digestive diseases 11 12 23 28. Nephritis 13 4 17 29. Puerperal and post-abortive sepsis — — — 30. Other maternal causes — — — 31. Premature birth 2 6 8 32. Congenital malformations, birth injury, infantile disease 4 1 5 33.Suicide — 4 4 34. Road traffic accidents 3 1 4 35. Other violent causes 12 12 24 36.All other causes 24 27 51 Totals 280 337 617 Over half the total deaths which occurred amongst Wimblodon residents in 1941 wore again due to cancer, diseases of the heart and circulation, and diseases of the respiratory system. Infantile Mortality. The are Wore twenty infant deaths (including transferable deaths) giving an Infantile Mortality Rate of forty-one per thousand live births. In 1940 the figure was forty-three per thousand. During 1941 the Infantile Mortality Rate for England and Wales was fifty-nine. 5. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Laboratory Facilities. The Corporation employ a part-time baotoriologist for the examination of pathological specimens. In addition, tho laboratory provic. at tho Health Centre is utilised for the examination of pathological specimons from the Infectious Diseases Hospital. This work is carried out by the staff of tho Public Health Department. MATERNITY" .AND CHlLD WELFARE The total number of visits paid by the Health Visitors during 1941, amounted to 6,334, the figure for the previous year being 7,218. Details of the home visits Carried. out are given below:- Number of Infants visited - First visits 453 Number of Infants visitod - Re-visits 1,043 Number of Toddlers visited 2,077 Ante-natal-First visits 283 Ante-natal-Revisits 84 Visits re Infant Deaths 3 " " Stillbirths 5 " " Ophthalmia Neonatorun 17 " " Puerperal Pyrexia 7 " " Non-notifiable Infectious Diseases 13 " " Milk. Applications 14 " " Foster Childres 110 " " Midwives 1 Miscellaneous 330 Total welfare visits 4, 440 Visits - School Medical Service 810 Tuberculosis - Home Visits 66 Vesits to Nursing Homes 14 Other visits 35 Ineffectual visits 909 1,084 Total visits 6,334 The reduction in the number of visits paid in 1941 is due mainly to the fact that there wore only four health visitors for the last nine months of the year. The Maternity and Child Welfare Centres remained open throughout the year. At Pelham Road Centre two sessions per week were heldi The average attendance at the..Tuesday sessions was 57.98 and at the Friday sessions" 52.96. At tho Cottenham Park Centre the average weekly,attendance wa3 33."2. Tho aver; p attendance at the Wan die Park Centre was 34.61. With tin erection of the Cottenham Park Centre, wher,e ; the average increased t y e_arly twenty por cent., the attendances showed substantial reductions. These are probably accounted for by the fact that many more women go out to work than in previous years, particularly in the southern part of the Borough. Ante-natal Clinic. Tho Pelham Road Ante-natal Clinio was held weekly and the average attendance was 15.57. At- the weekly Ante-natal Cliriic at Wandle Park, there was an average attendance of 8.25. The sessions at this Clinic were increased to two a month from the 4th September, 1941. Midwifery and Maternity Services - Midwives Act,1936. A service of whole-time domiciliary midwives is provided by the Wimbledon District Nursing and Midwifery Association under an agreement with the'Council. 6. Midwives Act, 1902-1936, The Council is the Local Supervising -ho ity for the Midwives Acts in Wimbledon. There yiore eight practising midlives in Wimbledon at the end of 1941, one of whom was resident outside the Borough. One hundred and forty-nino confinements were attended by midwives and seventeen by maternity nurses. • Medical.Aid forms were received in seventy-seven instances. The total fees paid to doctors by the Corporation during the year under Section 14 (1) of tho Midwives ^ct, 1918, amounted to £124,17s, 6d. The amount recovered from the patients' relatives was £64, 2s, 9d. Public Health Act, 1956 (Child Life Protection); Children and Young Persons Act. 193,3; Children .iCt, 1908 (Part 1).- The following figures relate to the administration of the above Acts in Wimbledon during 194-1. (i) Number of foster-mothers on tho Register - (a) At the beginning of the year 21 (b) At the end of the year 23 (ii) Number of children on the Register - (a) At the beginning of the year 40 (b) At the end of tho year 30 (c) Who died during the year - (d) On whom inquests were held during the year - Every foster-child was visited regularly. In all, one hundred and ten visits were made to the homes of foster-mothers. Treatment Facilities.- The Minor Ailment, Ophthalmic, Orthopaedic and aural Clinics remained open throughout the year. Facilities for the operative treatment of tonsils and adenoids remained available through the usual channels. Ophthalmia Neonatorum.- The following table shows that six cases of ophthalmia neonatorum were notified. In no case did any impairment of vision occur. CASES Vision Unimpaired. Vision Impaired To tal Blindness Deaths Notified Treated At Home Hospital 6 6 - 6 - - - Maternal Mortality. There was no maternal death amongst Wimbledon mothers in 1941, During 1940, one maternal death occurred. 7. The following table gives the maternal mortality rates for V/imbledon and also for England and Wales:- 1941 Puerperal Infection , Others Total Wimbledon: Per 1000 Live Births 0.00 0.00 0.00 Per 1000 Total Births 0.00 0.00 0.00 IJngland & Wales: Per 1000 Total Births 0.48 1.75 2.23 Hospital Treatment for Complicated Obstetric Cases.During 1941 twelve patiants received treatment under this Scheme. The cost of maintonanca and treatment of these patients amounted to £85.-s.-d. of which £18.16s.-d. was reoovered from the relatives. Supply of Mill: to Expectant and Nursing mothers and Infants.In addition to the National'"Millc Hacheme "a*dmlnist'er ocTby the Ministry of Food, 127 lbs. of dried milk wore supplied under the Maternity and Child Welfare Sohomo. Dental Treatment. Dental treatment is availablo for children under school ago, and for nursing and oxpoctant mothers. Thi3 Clinic continued without interruption throughout tho year. Municipal Day Nursery.- On tho outbreak of war the Nursory was evacuated to Arundel. In September 1940 the Nursery was transferred to Kindhead, and is now administered by tho surroy County Council on bohalf of the Wimbledon Council. Visits were paid to tho Nursory by the Chairman of the Wimbledon Maternity & Child Welfare Committee and tho Modical Officer of Health as circumstances permitted. The question of the provision of a time Nursery in the Nursery promises at Hubert Road was conciOrod in the latter part of the year. This resulted in proposals being submitted to the Ministry of Health and it v/as anticipated that tho Nursery would bo opened oarly in 1942. Nursing Homos Registration Act, 1927. Public Hoalth Act, 1936.Part VI. The Wimbledon Borough Council is responsible for the supervision of nursing homos in Wimbledon. At tho end of tho year there were eleven registered nursing homes. Fourteon visits of inspection wore made. SANITARY CI RCUMS TAN CSS OF THE AREA. Sanitary Inspection of District.- The following is a statement showing tho number ahd; nature of inspections made for tho year 1941. 8. Reason of Visit No. Infectious Disoases 548 House Inspections 3074 Inspections under Housing Acts 1936 27 Houso to House Inspections - Rant Act Inspections 3 Houses Let in Lodgings Inspections - Inspection of Factories, Workshops, Work- 118 Dairies and Cowsheds Inspections 51 Inspections under Shops Acts 22 Application of Tests to Drains 85 Inspections under Diseases of Animals' Acts 41 Obtaining Samples of Foods and Drugs 255 Miscellaneous (including Inspections of Food, slaughterhouses, mews, stables, caravans, Petroleum Acts, water supply, piggeries, 2626 Total 6850 Notices Served.Six hundred and seventy-one preliminary notices or intimations were served during the year. It was found necessary to serve one hundred and fifty statutory Notices. House Inspection.- The following table gives a summary of the nuisances abated and the sanitary improvements carried out, together with the defects remedied, as a result of house to house inspection under the supervision of tho Sanitary Inspectors:- 29 Cisterns provided - Cisterns repairedf cleansed or covered.. 5 Drains, now, provided 21 Drainago systems made wator-tight b;,' patent process 3 Drains, repaired or altered 30 Drains, stoppages removed 31 Dustbins provided 57 Flushing cisterns, new, provided 3 Flushing cisterns repaired 37 Manure receptacles provided - Rain-water pipes disconnected 1 Roofs repaired 192 Rooms stripped and cleansed 298 Verminous rooms cleansed 23 Soilpipes, new, provided 4 Soilpipes, repaired or altered - Vent pipes, new, provided 6 Vent pipos, repaired or altered 9 Waste pipos, new, provided 9 Waste pipes, repaired, disconnected or trapped 11 Water-closets,new,provided 29 Water-closets, repaired or ventilated 10 Water services restored 19 Water supply direct from main 4 Yards paved 6 Yaeds repaired 25 Grttering repaired 87 Floors ventilated 9 Nuisances from damp walls abated 185 Sinks provided 2 Other nuisances 792 Rooms disinfected 356 Total 2293 9. FACTORIES, WORKSHOPS AND WORKPLACES. 1. Inspections for purposes of provisions as to health. Premises. Numbor of Inspections . Written Notices Prosecutions Factories with mechanical pouer 106 5 - Factories without mechanical power 12 1 - Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises) Total 118 4 - 2. Defects found. Parti cul ars Number of Defects Prosecu tions Found Remedied Referred to H.M. Inspector. Want of Cleanliness (S.l) 1 1 — Overcrowding (S.2) — — — — Unreasonable temperature (3.3) — — — Inadequate ventilation (S.4) 1 1 — — Ineffective drainage of floors (S.6) _ _ Sanitary Conveniences (S.7) Insufficient 1 1 — — Unsuitable or Defective 1 1 — — Not separate for Sexos 1 1 — — Other Offences (Excluding offences relating to outwork and offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops) Order, 1921, and re-enacted in tho Third Schedule to tho Factories Act, 1937) 5 4 Totals 10 9 — — Outwork in Unwholesome Promises - (Section 108) Nature of work Instances Notices Served. Prosecutions Wearing Apparel - Making, etc. — — — Others — — — Outwork in Infected Premises - Sections 109-110 Nil. 10. HOME WORK. Lists received:- Twice in tho yoar —- Number of Outworkers — Onco in tho year 1 Number of Outworkers 1 Number of Outworkers' Premises on register 40 Number of addresses roceived fjom other Councils 10 Number of addresses forwanrdod to other Councils — Notices served on occupiers as to keeping or sending lists — Prosecutions - failing to kocp Outworkers' Lists — Prosecutions - failing to oirnish lists — Inspections of Outworkers' Premises 4 Number of unwholesomo promises — Notices sorved to remedy — OTHER MATTERS. Underground Bakehouses in use at the end of the year 3 Matters notified to H.M. Inspector of Factories:- Failure to affix Abstracts of Act Nil Action taken in matters referred by H.M. Notified by H.M. Inspector Nil Inspector as remedial under the Public Health Acts. ) Reports of action taken sent to H.M. Inspector Nil HOUSING. Number of dwelling-houses inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 — Number of inspections made for the purpose — Housing Act, 1936.- Part IV. - Overcrowding:- (a) (l) Number of dwellings overcrowded at the end of the year 18 (2) Number of families dwelling therein 30 (3) Number of persons dwelling therein 125½ (b) Number of new cases of overcrowding reported during the yoar — (c) (1) Number of cases of overcrowding relieved during tho year 4 (2) Number of persons concerned in such cases 25½ (d) Particulars of any oases in which dwellinghouses have again become ovorcrowded after tho local authority have taken steps for the abatement of Nil AIR RAID SHELTERS. Four hundred and ninety-throe visits wore paid to air raid shelters in the Borough. Thirty-four of these were carried out by the Medical Officer of Health or his Deputy, three hundred and fifty-three by the Sanitary Inspectors, and one hundred and six by the Health Visitors. In fifty-one instances defects due to inadequate lighting or ventilation, dampness, uncleanliness, or sanitary accommodation were reported to the A.R.P. Department for attention. INSPECTION AND SUPERVISION OF FOOD. Milk Supply.- Practically all the milk for retail sale is.brought into the area from other districts. The number of licences granted under the Milk (Special Designations) Order, 1936, was as follows:- . 11. Pasteurisers Licence — Dealers Licences: Tuberculin Tested Milk 2 Accredited Milk — Pasteurised Milk 9 Supplementary Licences 2 Bacteriological Examination.- Twenty samples of jnilk wore taken for bacteriological examination under the Milk (Special Designations) Order. Food and Drugs Act. 1958. The Council became tho Local Authority under thi3 Act on 1st October 1939. One hundred and fourteen samples were taken up to the end of the year. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. During 1941, four hundred and sixteen cases of infectious disease wore notified. These were one hundred and fifty-five more than in 1940. This increase is almost entirely duo to measles and whooping cough. For several years tho incidence of notifiable infectious disease in Wimbledon has boen low. Scarlet Fever.- Thirty-nine cases of scarlet fever were notified, one less than in 1940. The attack rate was 0.89 per thousand of the population. There was no death from scarlet fever. Thirty-eight, or 97.43 per cent of the cases were treated io hospital. There was no death frori this disease. Diphtheria.- The number of casec of diphtheria showed a slight increase, there being fifteen notifications in 1941 as compared with nine in the previous year. The attack rate was 0.20 per thousand of the population. All the patients received hospital treatment. There was no death. Diphtheria Immunisation.2 Sessions of the Immunisation Clinic were held every Week at 'the Healtn'-CfchtrB. On 17th April, these were increased to three sessions a week. rr Five hundred and forty children were Schick tested. Two hundred and ninety-five were found to be positive and then immunised. The total number of children immunisedwas One thousand one hundred and sixty. In all, five thousand six hundred and ninety-seven attendances were made for this purpose. Three hundred and seventy-four children attended for a subsequent Schick test. In fourteen cases they were found to be Schick positive and were re-immunised. Paratyphoid Fever. - Sight cases of paratyphoid fever were notified to the Department during July and August. Extensive investigations were carried out but it was not possible to trace any oommon source of infection. Food Poisoning.- This became a notifiable disease on 3rd October, 1939. Three notifications wore received during the yoar. Cerebro-Spinal Fever.- Nine cases of this disease wore notified. All the patients were treated in hospital, wore three deaths. Erysipelas.- Notifications wore received .in respect of nine cases of erysipelas. Two patients were treated in Hospital. Puerperal Pyrexia.- Two cases of puerperal pyrexia were notified. One of thoso patients was removed,to Hospital, There was no death From puerperal" s:epsis- amongst the patients notified under the Regulations. Measles.- Seventy-soyen cases of measles were notified. Seven of those wo're removed to hospital. There were no deaths. Whooping Cough.- There were one hundred and forty-four casos of this disease notified in 1941. Fourtoon cases wore treatod in hospital. There was one death. 12. 13 TABLE A. - NOTIFIABLE DISEASES DURING 1941. DISEASE Number of Cases Notified in Various Age Groups. Total Cases Notified Total Cas- Removed to Hospital Under 1 1-2 2-3 3-4 4-5 5-10 10-15 15-20 20-35 35-45 45-65 65 & over Smallpox - - - - - - - - - - - - - - Scarlet Eevcr - - 1 4 8 6 9 2 9 - - - 39 38 Diphtheria (including Memcrauous Croup) 1 _ 1 1 3 5 2 2 - - - 15 15 Entric Fever (including Paratyphoid) - - - - - 5 2 1 - - - - 8 8 Food Poisoning - - - - - - - J. 1 1 - 3 - Puerperal Pyrexia - - - - - - - - 2 - - 2 1 Measles 2 7 4 13 8 19 7 8 o - 2 1 77 7 Whooping Cough 18 17 15 18 19 55 - - 1 - - - 144 14 Acute Primary Pneumonia - - 2 - - 1 - 1 1 3 7 3 18 - Acute Influenzal do - - - - - - - - 1 - 1 - 2 - Corebro-Spinal Fever - - - - - - 2 3 1. 2 1 - 9 9 Acute Poliomyelitis - - - - - - 1 - - - 1 1 Acute Polio-encephalitis - - - - - - - - - - - - - - - Encephalitis Lethargica - - - - - - - - - - - - - - Dysentery _ - - - - - - - - - - - - - Malaria _ - - - - - - - - - - - - - Ophthalmia Neonatorum 6 - - - - - - - - - - - 6 _ Erysipelas - - - - - - 1 - 2 - 4 2 9 2 Tuberculosis (all forms) - - - - 1 2 4 12 43 11 9 1 83 59 TOTALS 26 25 23 36 37 91 30 29 70 17 25 7 416 154 14. TUBERCULOSIS - 1941. AGE GROUPS NEW CASES DEATHS Primary Notifications (Form A) New cases discovered otherwise than by notification i Total New Cases Pulmonary NonPulmonary Pulmonar 5 NonPulmona y Pulmonary NonPulmonary Pulmonary NonHilmonary Males Jtemales Moles Females Males Females Males Females Males Females Males Females Males Females Ma les Females Under 1 year - - - - - - - - - - - - - - 1 - 1-5 years - - - 1 1 - - - - - - - 1 - - - - 5 -10 ,, - - - 1 - - - 1 - - - 2 1 - - - 10-15 ,, - 1 1 - - 1 1 - - 2 2 - - - - 2 15-20 ,, 6 3 - 1 1 1 - - 7 4 - 1 1 2 - - 20-25 ,, 4 4 - 1 2 6 1 - 6 10 1 1 1 2 - 25-35 ,, 10 7 - 2 2 4 - - 12 11 - 2 2 6 - - 35-45 ,, 4 2 - 1 3 1 - - 7 3 - 1 2 3 - - 45-55 ,, - 3 - 1 - - - - - 3 - 1 2 1 - 55-65 ,, 1 2 - - 1 1 - - 2 3 - - 3 2 - - 65 and over 1 - - - - - - - 1 - - - 1 - - - 36 22. 1 3 9 14 2 35 36 3 9 13 16 1 2 48 9 23 3 71 12 29 3 57 26 83 32 TTJB-JRCULOCIG. « Eighty-throe eases of tuberculosis wcro notified. This figure shows an increase of sixteen on the number for the previous year. Tho deaths from tuberculosis wore six more than in 1940, the total figure being thirty-two. Twenty-nine of these were duo to pulmonary tuberculosis. During 1941, fifty-nine Wimbledon patients were admitted to sanatoria or hospitals. WIMBLEDON INFECTIOUS DISEASES HOSPITAL One hundred and ninety-two cases were admitted to the Infectious Diseases Hospital during 1941. as there were fifteen cases in hospital at the end of 1940, the total number of cases under treatment during the year amounted to two hundred and -seven. One hundred and nineteen of there cases were from Wimbledon, and eightyeight from Kingston. Of the two hundred and seven patients under treatment, ninetythree were suffering from scarlet fever, thirty-three from diphtheria and twenty-three from cerebro-spinal meningitis, thirteen from enteric fever, twenty from measles and twenty-five from other diseases. There was one death during the year, which was due to poliomyelitis. Twenty-one patients remained in hospital at the end of 1941. Fifteen of these were suffering from scarlet fever, two from otitis media, two from diphtheria, one from croup, and one from poliomyelitis. In concluding this report I should like to express my deep appreciation to the Chairman and members of the Public Health and Maternity and Child Welfare Committees for the consideration and courtesy which they have again shown me during 1941. It is also a pleasure to draw attention to the help and co-operation which I have received from all members of the staff. I have the honour to be Your obedient servant, HAROLD ELLIS. 15.